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PubMed1994

International symposium on epidermolysis bullosa. The William and Ida Friday Continuing Education Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, April 25-26, 1994. Abstracts.

An international symposium on inherited epidermolysis bullosa was held at the University of North Carolina at Chapel Hill on April 25-26, 1994. All areas currently of clinical and research interest pertinent to this disease were discussed, ranging from basic epidemiologic issues to the definition of molecular defects in each of the three major types of epidermolysis bullosa and the potential for gene therapy. A major focus of this meeting was the presentation of data collected by the National Epidermolysis Bullosa Registry.

Epidermolysis Bullosa↗
PubMed1999

Population-based study of chronic lung disease in very low birth weight infants in North Carolina in 1994 with comparisons with 1984. The North Carolina Neonatologists Association.

OBJECTIVE: To assess the pulmonary outcomes of very low birth weight (VLBW) infants in North Carolina in 1994 and to compare rates of survival and chronic lung disease (CLD) between 1994 and 1984 (see reference 2). METHODS: Data were collected prospectively by collaborators from all 13 neonatal intensive care units in North Carolina to determine survival and pulmonary outcomes of infants with birth weights of 500 to 1500 g. State vital statistics data were used to confirm completeness of the sample. CLD was defined as oxygen or ventilator therapy at 36 weeks' postmenstrual age (PMA). For comparisons with the 1984 cohort, survival and pulmonary outcomes of infants defined to be at risk for CLD (ventilated >48 hours and survived 30 days) were recorded at 30 days, 3 months, and 6 months of postnatal age. RESULTS: Outcome data were available for 1413 (92%) of the in-state VLBW live births. Of VLBW infants, 224 (15%) died before 48 hours of age. The overall rate of CLD in 1994 at 36 weeks' PMA was 25%. Rates by birth weight group were 57% for 500 to 750 g birth weight (BW), 41% for 751 to 1000 g BW, 19% for 1001 to 1250 g BW, and 8% for 1251 to 1500 g BW. Infants who received ventilator therapy for >48 hours accounted for 89% of the CLD cases. The CLD rate at 36 weeks' PMA in infants weighing 751 to 1500 g was 37% for those ventilated >48 hours versus 5% for those ventilated <48 hours (OR: 7.1; 95% CI: 4.4-11.3). Overall survival in 1994 was significantly higher for infants than in 1984 (78% vs 74%), most notably in infants 500 to 750 g BW (37% vs 24%), and 751 to 1000 g BW (82% vs 65%). When compared with 1984, the CLD rates in those infants defined to be at risk were significantly higher in 1994 at 30 days (68% vs 54%) and at 3 months (24% vs 15%) of postnatal age. For at-risk infants in 1994, there were fewer infants on the ventilator, but more infants on oxygen alone at all measured time points compared with 1984. CONCLUSION: Survival of VLBW infants has improved since 1984. Ventilator therapy for >48 hours remains a significant risk factor for CLD. The incidence of CLD has increased from 1984 to 1994 but has shifted from ventilator to oxygen therapy. bronchopulmonary dysplasia, epidemiology, infant, low birth weight, intensive care units, neonatal statistics, infant mortality, prospective studies.

Chronic Disease↗
PubMed2004

Documenting the sustainability of a mature Click It or Ticket program: the North Carolina experience.

North Carolina was the first United States jurisdiction to implement a statewide program (called Click It or Ticket) coupling concentrated enforcement with massive publicity to increase seat belt use. After a successful pilot program in three very different North Carolina communities, the statewide program was launched in October 1993, and has been most active and productive as well as imitated by many other states over the past decade. This paper explores the combination of ingredients that have been employed and sustained over that period of time. These include: (a) a basic coalition of critical public-private agencies (central to the planning, execution, and publicity of the many Click It or Ticket programs); (b) critical top-down commitments (starting with the governor); (c) pervasive and innovative media events/press releases/ PSAs/ web site information; (d) vigorous and well-publicized law enforcement; (e) feedback on results with solid, updated data; (f) related statewide and local programs/activities; and last but not least (g) continuous funding.

Accidents, Traffic↗
PubMedDate not supplied

Antibiotic prescriptions associated with outpatient visits for acute upper respiratory tract infections among adult Medicaid recipients in North Carolina.

BACKGROUND: North Carolina and the southeastern United States have the highest antimicrobial resistance rates for common respiratory tract pathogens in the nation. The excessive use of antibiotics for common outpatient infections is a major contributing factor in the emergence of antibiotic resistant bacteria. OBJECTIVE: To estimate the prevalence of oral antibiotic treatment for acute, nonbacterial respiratory tract infections among adult Medicaid recipients in North Carolina, and to describe a pilot project aimed at reducing the prevalence of oral antibiotic treatment among this population. METHODS: Using administrative claims data, we identified 24,137 Medicaid recipients, aged 18 to 64 years, who made at least one outpatient physician visit for acute nasopharyngitis (ICD-9, 460.x), acute pharyngitis (462.x), acute upper respiratory infection (465.9), acute bronchitis (466.0), or influenza (487.1) between October 1, 2000, and March 29, 2001. We excluded adults with chronic bronchitis (ICD-9, 491.x), emphysema (492.x), asthma (493.x), or chronic obstructive pulmonary disease (496.x). Pharmacy claims data were used to identify oral antibiotic treatment that occurred within 5 days of the outpatient visit. RESULTS: Overall, 63% (n = 15,189) of Medicaid recipients who made at least one outpatient visit during the observation period for one of the study conditions had a prescription filled for an oral antibiotic within 5 days. Residence in a rural county (64% vs. urban, 61%, p < 0.01) and in the eastern region of the state (65% vs. western region, 59%, p < 0.01) was associated with receipt of an antibiotic. Compared with the other principal study diagnoses, patients with acute bronchitis (44% of all outpatient visits) were 2.88 (95% CI = 2.72, 3.05) times more likely to receive oral antibiotic treatment after multivariate adjustment. SUMMARY: The prevalence of oral antibiotic treatment among adult Medicaid beneficiaries diagnosed with nonspecific upper respiratory infections, colds, pharyngitis, bronchitis, and influenza is high and varies significantly across patient demographics and geography. Interventions to reduce antibiotic prescribing are needed to reduce the progression of antimicrobial resistance.

Administration, Oral↗
PubMed2005

Summer weeds as hosts for Frankliniella occidentalis and Frankliniella fusca (Thysanoptera: Thripidae) and as reservoirs for tomato spotted wilt Tospovirus in North Carolina.

In North Carolina, Tomato spotted wilt tospovirus (family Bunyaviridae, genus Tospovirus, TSWV) is vectored primarily by the tobacco thrips, Frankliniella fusca (Hinds), and the western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae). TSWV overwinters in winter annual weeds from which it is spread to susceptible crops in spring. Because most susceptible crops are destroyed after harvest before winter weeds emerge in the fall, infected summer weeds are thought to be the principal source for spread of TSWV to winter annual weeds in fall. A survey of summer weeds associated with TSWV-susceptible crops in the coastal plain of North Carolina conducted between May and October revealed that relatively few species were commonly infected with TSWV and supported populations of F. fusca or F. occidentalis. F. occidentalis made up > 75% of vector species collected from 15 summer weed species during 2002. The number of F. occidentalis and F. fusca immatures collected from plant samples varied significantly among plant species. Ipomoea purpurea (L.) Roth, Mollugo verticillata L., Cassia obtusifolia L., and Amaranthus palmeri S. Wats supported the largest numbers of immature F. occidentalis. Richardia scabra L., M. verticillata, and Ipomoea hederacea (L.) supported the largest numbers of F. fusca immatures. TSWV was present at 16 of 17 locations, and naturally occurring infections were found in 14 of 29 weed species tested. Five of the TSWV-infected species have not previously been reported as hosts of TSWV (A. palmeri, Solidago altissima L., Ipomoea lacunosa L., I. purpurea, and Phytolacca americana L.). Estimated rates of infection were highest in I. purpurea (6.8%), M. verticillata (5.3%), and I. hederacea (1.9%). When both the incidence of infection by TSWV and the populations of F. occidentalis and F. fusca associated with each weed species are considered, the following summer weed species have the potential to act as significant sources for spread of TSWV to winter annual weeds in fall: I. purpurea, I. hederacea, M. verticillata, A. palmeri, C. obtusifolia, R. scabra, Ambrosia artemisiifolia L., Polygonum pensylvanicum L., and Chenopodium album L.

Animals↗